XGEVA 120 mg/1.7mL Injection

Also known as Denosumab. Coverage in Alaska (CMS PDP Region 34).

4 of 9 stand-alone Part D plans in Alaska cover this drug on tier 5.

4 of 4 plans apply a prior authorization, step therapy or quantity limit.

Every plan that covers it

Plan	Tier	30-day preferred	90-day mail	Unit cost	Est. 30-day fill	Restrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$2475.0700	$4,950.142 units	Prior authorization Quantity limit 1.7 per 28 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1973.6214	$3,947.242 units	Prior authorization Quantity limit 1.7 per 28 days
Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible	5Specialty Tier	26%	—	$1973.6214	$3,947.242 units	Prior authorization Quantity limit 1.7 per 28 days
Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible	5Specialty Tier	33%	—	$1973.6214	$3,947.242 units	Prior authorization Quantity limit 1.7 per 28 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity.

See coverage in all 39 regions →